Wasser et al. BMC Nephrology (2018) 19:128 https://doi.org/10.1186/s12882-018-0923-4

RESEARCH ARTICLE Open Access

Emergence of an Israel faith-basedcommunity organization facilitating livedonor kidney transplantation

Walter G. Wasser1,2*† , Geoffrey Boner3†, Meni Koslowsky4,5 and Adi Lazar6

Abstract

Background: The 2014 Consensus Conference on Best Practices in Living Kidney Donations recognized live donorkidney transplantation as the best treatment for late-stage kidney disease, yielding superior graft and patientsurvival, improved quality of life, fewer requirements for dialysis and increased cost-effectiveness compared todeceased donor kidney transplantation. Yet in spite of the excellent results of living kidney donation, the annualnumber of living kidney donors is declining in many countries, including the United States. In Israel, a non-profitorganization, Matnat Chaim (“Gift of Life” in Hebrew), a faith-based initiative, has emerged as a major force forarranging living donor kidney transplantation mainly by facilitating altruistic living unrelated donor transplantation.

Methods: A retrospective review of the records of live kidney donations facilitated by the Matnat Chaim organizationand referred to Israel transplant centers, since the organization’s inception in 2009, was performed and compared topublished data from the Israel Ministry of Health.

Results: Matnat Chaim has facilitated 494 live kidney donations since its founding in February 2009 until the end of2017. Of the 124 live kidney transplants performed in 2016, 111 (90%) were shown to be altruistic and unrelated. Thislarge number of donations was associated with a doubling of the total number of kidney transplantations, performedin Israel (data published by the Israel Ministry of Health).

Conclusions: The success of an Israel community organization in the promotion of kidney transplantation may serveas a model for other religious and non-religious communities worldwide.

Keywords: Altruism, Kidney transplant, Community organization

BackgroundKidney transplantation: The most effective form of kidneyreplacement therapy worldwideKidney transplantation results in both an increase in lifeexpectancy and quality of life, as compared to individualstreated with dialysis [1–3]. Kidneys from deceased donorsare the major source of organs for kidney transplantationworldwide [4, 5]. However, only a few countries have beenable to obtain sufficient numbers of deceased donor organsto supply the needs of individuals waiting for kidney trans-plantation [6]. This has resulted in potential recipients

* Correspondence: Lcdialysis@aol.com†Walter G. Wasser and Geoffrey Boner contributed equally to this work.1Division of Nephrology, Mayanei HaYeshua Medical Center, 51544 Bnei Brak,Israel2Rambam Health Care Campus, 3109601 Haifa, IsraelFull list of author information is available at the end of the article

© The Author(s). 2018 Open Access This articInternational License (http://creativecommonsreproduction in any medium, provided you gthe Creative Commons license, and indicate if(http://creativecommons.org/publicdomain/ze

having to remain on dialysis for a prolonged period, withmany patients dying before receiving a graft. Initially, kid-neys from living donors were only used when the donorwas related to the recipient. Since the early 1970’s, advancesin immunosuppression have resulted in kidney survivalrates from non-related donors, which are similar to thoseobtained using organs from related living donors [6]. Thishas led to an increase in the number of altruistic living kid-ney donations. The United States Renal Data System 2015report shows that 31% of all kidney donations are from livedonors [4]. In addition to offering superior patient survival,kidney transplantation also results in a substantial eco-nomic savings as compared to treatment with dialysis [7].A preemptive living donor transplant, before starting

dialysis, has been shown to result in the best survival[8–10]. Now, 60 years after the performance of the first

le is distributed under the terms of the Creative Commons Attribution 4.0.org/licenses/by/4.0/), which permits unrestricted use, distribution, andive appropriate credit to the original author(s) and the source, provide a link tochanges were made. The Creative Commons Public Domain Dedication waiverro/1.0/) applies to the data made available in this article, unless otherwise stated.

http://crossmark.crossref.org/dialog/?doi=10.1186/s12882-018-0923-4&domain=pdfhttp://orcid.org/0000-0003-0251-1325mailto:Lcdialysis@aol.comhttp://creativecommons.org/licenses/by/4.0/http://creativecommons.org/publicdomain/zero/1.0/

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living donor transplant, more than 27,000 living donorkidney transplants are being performed annually world-wide [11, 12]. Yet, the availability of living kidney donorshas stagnated or declined in the United States, Canada,Australia, New Zealand, Brazil and Europe, while exhi-biting some growth in Japan and South Korea [13]. Inspite of the excellent results of living donor kidneytransplants in the United States, there has been a 10%decline from 6647 to 5989 in the years 2004 to 2013.Disproportionate decreases were seen in some sub-groups, including males, related donors and donors agedless than 50 years [14–16].Kidney donation is a decision with lifetime health im-

plications. Given the relative safety of the surgical pro-cedure itself, the central concern in relation to theremoval of one kidney from a healthy individual is thelong-term risk of progressive chronic kidney disease(CKD). However, there are long term studies in whichthe risk for kidney disease has remained small [17, 18];the attributable risk for eventual kidney failure has beencalculated at 27 per 10,000 (0.3%) at 15 years [17]. Thereis insufficient data available to determine lifetime attrib-utable risk [19].Barriers and challenges are faced by patients and their

families in arranging kidney donation. In order to assistindividuals with kidney failure to overcome these bar-riers in finding live kidney donors, transplant programshave established training seminars to teach potentialtransplant patients and their loved ones strategies tofacilitate a living kidney donation [20]. Designated indi-viduals are sometimes called “live donor champions”.

Fig. 1 Kidney transplants in Israel, 2004–2016. This figure demonstrates thedonor transplants (red) deceased donor kidney transplants (green) to those facilitincrease in the total number of transplants, and this is mainly due to the increaseThe number of transplants was obtained from the Israel Ministry of Health (http:/

Friends, family members or community members aretrained by transplant centers to assist patients in findingaltruistic kidney donors.

History of kidney transplantation in IsraelKidney transplantation has been available in Israel sincethe mid-1960s. The first two kidney transplants, onefrom a living related donor and the second from a de-ceased donor, were performed at approximately thesame time at two different hospitals. Afterwards, kidneytransplantation began to be performed in several hospi-tals throughout the country, but the overall numbersremained small.In 1994, the National Transplant Center was estab-

lished as an Israel governmental organization. The ob-jectives of the organization were to promote organtransplantation, to maintain a central list of potentialtransplant candidates, to select recipients as organs be-came available, according to established criteria, and toprovide guidelines for various functions, such as selec-tion of patients and collection of data. In spite of this,the number of kidney transplants remained less than150 per year in the early 2000s (Fig. 1), a number insuffi-cient to satisfy the needs of the relatively large number ofpotential recipients on the waiting list (Table 1). As a re-sult of this, many Israelis with kidney disease travelled toother countries in order to undergo kidney transplantationusing live or deceased donor kidneys. In some cases, thisinvolved “organ trafficking”, which led to severe legislationand sanctions based on the adoption of Istanbul declar-ation principles (see below) [21].

total number of kidney transplantations (blue), comparing the livingated by Matnat Chaim (purple). Starting in 2009, there has been a sharpin the number of live donor transplants, largely facilitated by Matnat Chaim./www.health.gov.il/Subjects/Organ_transplant/transplant/Pages/default.aspx)

http://www.health.gov.il/Subjects/Organ_transplant/transplant/Pages/default.aspx

Table 1 Number of individuals with late-stage chronic kidneydisease (CKD) in Israel on the waiting list for kidney transplantation

Year Number of patients on the waitinglist for kidney transplantation

2004 453

2005 487

2006 490

2007 518

2008 540

2009 598

2010 690

2011 733

2012 729

2013 755

2014 762

2015 849

2016 843

2017 847

Source: The Ministry of Health, Israel (http://www.health.gov.il/Subjects/Organ_transplant/transplant/Pages/waiting_for_transplants.aspx)The number of individuals with late-stage CKD in Israel on the waiting list forkidney transplantation has doubled in 13 years, but stabilized over the pastthree years. This could be largely due to the result of the efforts of the MatnatChaim organization, established in 2009, which has facilitated an increasingnumber of Israeli kidney donors, especially over the past three years

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In 2008, the Israeli Knesset enacted two laws [22–24].The first defined brain death and provided the criteriafor diagnosing brain death [25]. The second law, thetransplantation law. defined the conditions for perform-ing transplants using deceased and live donors in Israel[26, 27]. Furthermore, it made direct payments to do-nors and agents illegal [26]. Remuneration for loss of in-come was permitted and regulated. The regulationsregarding the requirements for the use of organs fromliving donors were published. These included the com-pletion of physical and psychological testing in one ofthe recognized transplant centers.In addition, related donors are required to receive the

approval of an independent committee in the hospital ofthe transplant center, whereas altruistic non-related do-nors are referred to an independent national committeefor the approval of such donors. This committee re-quires not only the data from the transplant center, butpresentation of data on the potential recipient and an in-dependent psychological examination before confirmingthe particular donor-recipient pair. The performance oforgan transplantation in foreign countries is allowedonly in countries with strict regulations preventing organtrafficking. During the same year (2008), the IstanbulDeclaration supported the prohibition of organ traffickingand transplant tourism [21]. This created a decrease in thenumber of Israeli patients obtaining kidney transplants in

foreign countries, which resulted in an increase in thenumber of patients on the waiting list for kidney trans-plantation starting in 2008 (see Table 1).

The attitude of Jewish religious leaders regarding organtransplantationHistorically, many, but not all, rabbinic authoritiesrejected the use of organs from deceased donors fortransplantation [25]. The main objection was related tothe definition of brain death, which is not considered ac-ceptable to many rabbinical authorities, as opposed tocardiac death, which was universally accepted [28]. Theharvesting of organs from a non-heart beating deceaseddonor is considered permissible by even the most strin-gent rabbinic authorities. Although in recent years therehas been an increase in the percentage of families allow-ing the use of organs from deceased relatives, there hasbeen no substantial increase in the actual number of de-ceased donors (Figs. 1 and 2). In contrast, while theremay be some dispute regarding nonliving kidney dona-tion, a virtual unanimity of opinion amongst all rabbinicauthorities is to encourage, but not to require, livingdonor kidney donation [29].

Matnat Chaim encourages live kidney donation amongOrthodox Jews in IsraelThe primary function of Matnat Chaim, a registeredIsrael non-profit organization (https://kilya.org.il/en/), isto encourage altruistic living kidney donation of Israelicitizens with an emphasis on donors from the OrthodoxJewish community. Matnat Chaim generates initial inter-est primarily through awareness-raising campaigns inthe media, both traditional media, such as newspapers,magazines, radio and television, as well as new media,such as internet and social media sites, especially Face-book. The organization produces magazine supplementsthat disseminate stories describing the life and sufferingof dialysis patients, as well as inspiring stories of kidneydonors. As individuals, who have been exposed to a mediacampaign or who have heard about the organization, ex-press an interest, Matnat Chaim invites these potential do-nors and their families to meetings where they may speakindividually with staff and obtain medical information onkidney donation. The organization helps donors navigatethe health system, and refers them to physicians withparticular experience in advising kidney donors. Theorganization attempts to promote living related donationas a priority before matching the transplant candidate withan unrelated altruistic donor. It will not directly attemptto persuade a non-relative to donate a kidney. Only pre-liminary donor screens are provided via the organizationwith preliminary medical testing for kidney donation per-formed by the health maintenance organization (HMO)family physician. Potential donor and recipient pairs are

https://kilya.org.il/en/http://www.health.gov.il/Subjects/Organ_transplant/transplant/Pages/waiting_for_transplants.aspxhttp://www.health.gov.il/Subjects/Organ_transplant/transplant/Pages/waiting_for_transplants.aspx

Fig. 2 Kidney transplants in Israel by donor source from 2007 to 2016 (number of transplants per million population). The number of deceaseddonor transplants (blue) has increased by 64%, whereas the number of living donor transplants (red) has increased by 174%. The number oftransplants was obtained from the Ministry of Health and the population figures from the National Bureau of Statistics

Wasser et al. BMC Nephrology (2018) 19:128 Page 4 of 8

then referred to a transplant center, where further exami-nations are performed and where it is decided whetherthe potential recipient and donor are compatible andmedically suitable. In the case of an altruistic donor thedonor-recipient pair is further interviewed by the NationalCommittee for Altruistic Donors, which by law must takeultimate responsibility in approving each altruistic kidneydonation to ensure inter alia that there is no commercialcomponent.Potential donors often request to donate to a person

with specific characteristics, such as a child, a mother ofsmall children, a non-smoker, or a member of a specificreligious group. Although kidney donors are allowed tochoose specific characteristics of the recipient, donorsare not permitted to choose a specific recipient. Donorsatisfaction and thereby the number of donors is in-creased by allowing donors this prerogative, the compel-ling benefit of which is considered by the NationalCommittee for Altruistic Donors to outweigh potentialharm. Relevant information is provided to the commit-tee with consent of the participants.The purpose of this paper is to describe the establish-

ment of an organization for the facilitation of live kidneydonations to Israel transplant centers wherein the do-nors are mostly from the Israeli Orthodox Jewish com-munity. We hope to demonstrate how this organizationaffected the numbers of total kidney transplants by refer-ring to data published by the Israel Ministry of Health.

MethodsWe performed a retrospective, record-based study of the382 live kidney donor transplants facilitated by the

Matnat Chaim Organization in Israel transplant centers(https://kilya.org.il/en/). Criteria for inclusion in thestudy were individuals referred by the organization forkidney transplantation after the establishment of theorganization in February, 2009 until December 2016.These data were then compared to the total number ofkidney transplantations performed from January 2004 toDecember 2016 (Israel Ministry of Health website). Datautilized in the figures and tables accessed from a link tothe Ministry of Health (http://www.health.gov.il/Subjects/Organ_transplant/transplant/Pages/default.aspx) and theIsrael National Bureau of Statistics http://www.CBS.gov.ILThe current study was conducted under the Ariel

University Institutional Review Board. Since this was aretrospective record based study, no patient consent wasrequired by the board.

ResultsThe number of kidney transplants performed in Israel isdepicted in Figs. 1, 2, 3. From 2004 until 2010 the yearlynumber of transplants ranged from 127 to 152 with ap-proximately equal numbers of deceased kidney donorsand live kidney donors. The numbers per million popu-lation are shown in Fig. 2. Following the passage of theTransplant law in 2008, the publication of criteria for re-imbursement and the publication of preferential treat-ment for recipients whose family had previously donatedorgans or signed a donor card resulted in an increase inthe number of deceased donors from a maximum of 87until 2010 to 117 in 2013 and 115 in 2016 (Fig. 1). Thenumber of live kidney donors increased from 78 in 2010to 222 in 2016.

https://kilya.org.il/en/http://www.health.gov.il/Subjects/Organ_transplant/transplant/Pages/default.aspxhttp://www.health.gov.il/Subjects/Organ_transplant/transplant/Pages/default.aspxhttp://www.cbs.gov.il

Fig. 3 Total number of live donor transplants in Israel from 2010 to 2016 (number of transplants per million population). The number of livedonor transplants in Israel is composed of those transplants facilitated by Matnat Chaim and other donors (i.e., those that were not facilitated byMatnat Chaim). This figure shows that the number of other live donor kidney transplants has remained stable at around 10 per million inhabitantsover the past few years. The increase in total number of living donors per million inhabitants since 2013 appears due to the increase in donorsfacilitated by the Matnat Chaim organization. The “other donors” represents family members who donated not using Matnat Chaim as well as a smallnumber of altruistic donors who went directly to a hospital or to the Israel Ministry of Health

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The number of kidney transplants per year per millionpopulation in Israel is presently 39. This places Israel inthe group of countries performing 30 to 51 kidney trans-plants per million population, which includes 42% ofcountries worldwide [4]. The increase in the number ofkidney transplants has resulted in a plateau in the num-ber of patients on the transplant waiting list (Table 1).At the end of 2016, 847 individuals were listed on theIsrael kidney transplant waiting list, representing 13% ofthe 6532 patients treated with renal replacement therapy.The establishment of Matnat Chaim in 2009 was asso-

ciated with a major increase in the number of live donorkidney transplants performed in Israel (Fig. 1). In 2011only 27% of live donors were referred by Matnat Chaimwhereas by 2015, 51% of all live kidney donors were re-ferred by Matnat Chaim and by 2016 it had increased to55% (Fig. 3). Matnat Chaim facilitated 4 live donor kid-ney transplants in 2009, 11 in 2010, 32 in 2011, 37 in2012, 33 in 2013, 49 in 2014, 89 in 2015, 127 in 2016and 112 live donor kidney transplants in 2017. In 2016,three of the 127 transplants facilitated by Matnat Chaimwere altruistic donations from non-Israelis to citizens ofother countries. The total number of live kidney dona-tions facilitated by Matnat Chaim until the end of 2017was 494. The mean age of these kidney donors was41 years with the age range between 23 and 66 years;73% were male and 27% were female.Virtually all the donors referred by Matnat Chaim

were altruistic. Specifically, of the 124 donors in Israelreferred by Matnat Chaim in 2016, 111 (90%) were altru-istic unrelated donations and only 13 (10%) were related

to the recipient. In 2017, of 112 kidney donations, 98(88%) were altruistic and 14 (22%) were related.During the calendar year 2016, Matnat Chaim referred

324 potential kidney donors for evaluation. Of these, 185were rejected for kidney donation by the family phys-ician or the transplant center for medical reasons, in-cluding hematuria, proteinuria, hypertension, obesity(BMI > 30), low glomerular filtration rate, nephrolithia-sis, cysts, and psychological problems. Furthermore, 12potential kidney donors referred by Matnat Chaim thathad been accepted for kidney donation by Israel trans-plant centers were rejected by the National Committeefor Altruistic Donors without explanation.

DiscussionIndividuals with advanced kidney failure are understand-ably overwhelmed with the tasks associated with caring forthemselves due to their severe physical illness, in additionto depression often associated with kidney disease [30].Even with family support, many find the task of finding asuitable kidney donor to be unachievable. This has resultedin transplant programs training individuals to assist per-sons with late-stage kidney disease to organize kidneytransplants. The emergence of a faith-based organizationin Israel, whose purpose is to arrange living donor kidneytransplantation, has resulted in a sharp increase in thenumber of live donor transplants, and represents a new de-velopment of advocacy for individuals with kidney diseasethat might garner wider activity. To the best of our know-ledge, there are no previously published descriptions ofsimilar live donor community organizations.

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The impressive increase in numbers of live kidneydonations, emanating mainly from the Orthodox Jewishcommunity in Israel, resulted in a sharp increase innon-related altruistic donors and provided almost all thesealtruistic donors as shown in the number of kidney trans-plant donors for 2016. The success of this organization,has generated a debate regarding the ethics of directed livekidney donations by ethnicity. Ethicists voice conflictingopinions on this point. Some ethicists find the practice ofdirected live kidney donation acceptable [31] while othersoppose the practice that kidney donors be allowed tochoose the recipient [32]. These ethicists compare livekidney donation to deceased donation where the family isnot allowed to choose the recipient and the recipient ischosen from a list, according to a medical priority settingalgorithm [32]. Israeli law relegates these decisions to theNational Committee for Evaluation of Living Donors whoadjudicates the propriety of every nonrelated altruistic kid-ney donation. In turn, the committee policy has been toallow potential nonrelated donors to choose the character-istics of recipients in order to increase the number of livekidney donations for the benefit of all.What features account for the success of this program?

Persuasive elements of previous programs, such as thosethat utilize live-donor champions [20] or programs thatadvertise for kidney donors in print and social media[33] are also utilized by this organization. These includethe use of “nonargumentative influence”, persuasive ap-proaches to shaping behavior that does not attempt touse reason and rather utilizes emotional appeals, such asallowing the individual with kidney disease to tell his/her specific story [34]. The other very useful persuasiveapproach utilizes a “messenger effect”, the use of influ-ential figures, such as peers or community leaders, tech-niques that give the kidney donation message greaterweight in the eyes of the potential kidney donor [34].The organization under the direction of Rabbi Heber, acharismatic and inspiring person, effectively utilizes thisapproach. The use of patient navigators by MatnatChaim is another innovation that has been previouslyshown in a randomized, controlled trial to double theeffective completion of the kidney transplant process byrecipients [35].Probably the most important and significant reason

for the success of the program is the religious and spir-itual importance that the kidney donors place on fulfill-ing the religious edict of saving another person’s life.This is epitomized by the Talmudic passage in theBabylonian Talmud, Tractate “Sanhedrin”, page 37astates that “he who saves one life is as if he has savedthe entire world” [36].One of the possible ethical problems of the activities

of such a non-profit organization is the acceptance ofdonations from the public and from the families of

potential recipients. It may be insinuated that such do-nations might possibly advance certain recipients. Ac-cordingly, it is strongly recommended that fundraisingand philanthropic support for such organizations mustbe led, handled, and processed by individuals not con-nected with the identification of potential kidney do-nors, or allocation to recipients. The limitations of thisstudy are that the donor-recipient pairs have not beencross-identified to allow detailed description of theircharacteristics and a long-term study of the results ofkidney transplantation on these individuals is not avail-able. Recently, data regarding the low absolute risk forkidney failure among live donors, have been reported[37] and practice guidelines on the evaluation and careof live kidney donors have been published [38].The Israel Transplant law was enacted in 2008 and

Matnat Chaim began to facilitate live donor kidney trans-plants in 2009. The Israel Transplant law was associatedwith a dramatic reduction in the number of Israelis obtain-ing kidney transplants in countries outside Israel [39]. Thislegislation may have also played a coincident role in theoutcome of increasing living kidney donations withinIsrael, thus facilitating the contribution of Matnat Chaim.An additional benefit of the increase in the number of

kidney transplants related to the activities of the MatnatChaim organization is the estimated savings to the IsraelMinistry of Health Budget. A recent investigation of kid-ney transplantation in Sweden showed a substantial sav-ings due to kidney transplantation compared totreatment with dialysis [40]. Similarly, we estimate thatthe 494 individuals who received a kidney transplant dueto the activities of Matnat Chaim will save the Israelhealthcare budget an estimated $25 million in dialysiscosts annually. This savings may be usefully con-trasted with the reported Matnat Chaim annual oper-ating budget of less than $1 million, raised totallyfrom private funds.Furthermore, studies are required to explore and to

further understand emotional responses as an importantmotivator for living kidney donation. In particular, sev-eral of the present authors are examining demographicand psychological characteristics of past kidney donorsfor the purpose of developing a profile to identify poten-tial future donors. It remains to be seen whether similarorganizations of different religious and non-religious in-dividuals can alter the donation rate in other countries.

ConclusionsMatnat Chaim is an Israeli not-for-profit organizationthat has succeeded in facilitating 494 live kidney dona-tions since its establishment in 2009 until the end of2017, contributing to the doubling of the number of kid-ney transplantation procedures performed in Israel. Theorganization achieves its success by personalizing the

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kidney transplant process and addressing a potential do-nor’s concerns during the decision making process.Matnat Chaim is a unique kidney transplant successstory that may serve as a model when applied in otherreligious and non-religious transplant community orga-nizations worldwide.

AcknowledgementsThe authors are indebted to Judith Abrahams, Ph.D. for making the MatnatChaim file data available to us for review and to the manuscript reviewersfor their helpful suggestions.

Availability of data and materialsDataset obtained from Matnat Chaim Organization of donors referred totransplant centers (https://kilya.org.il/en/). This data was then compared tothe total number of kidney transplantations performed from January 2004 toDecember 2016 obtained from the Israel Ministry of Health website. Thisdata was accessed from a link to the Ministry of Health http://www.health.gov.il/Subjects/Organ_transplant/transplant/Pages/default.aspx and the Israel NationalBureau of Statistics http://www.CBS.gov.il.

Authors’ contributionsWGW, GB, MK, and AL conceived of the contents of the article and carriedout the research. WGW and GB prepared the drafts of the manuscript. Allauthors were involved in the revision of the draft manuscript and haveagreed to the final content.

Ethics approval and consent to participateEthics approval waiver was obtained from the Ariel University InstitutionalReview Board. Since this was a retrospective record based study, no patientconsent was required by the board.

Competing interestsThe authors declare that they have no competing interests.

Publisher’s NoteSpringer Nature remains neutral with regard to jurisdictional claims inpublished maps and institutional affiliations.

Author details1Division of Nephrology, Mayanei HaYeshua Medical Center, 51544 Bnei Brak,Israel. 2Rambam Health Care Campus, 3109601 Haifa, Israel. 3Department ofMedicine, Tel Aviv University Sackler Faculty of Medicine (retired), Tel AvivUniversity, Ramat Aviv, 6997801 Tel Aviv, Israel. 4Departments of Psychology,Bar-Ilan, 52900 Ramat Gan, Israel. 5Ariel University, 44837 Ariel, Israel.6Department of Economics, Ariel University, 44837 Ariel, Israel.

Received: 22 December 2017 Accepted: 18 May 2018

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AbstractBackgroundMethodsResultsConclusions

BackgroundKidney transplantation: The most effective form of kidney replacement therapy worldwideHistory of kidney transplantation in IsraelThe attitude of Jewish religious leaders regarding organ transplantationMatnat Chaim encourages live kidney donation among Orthodox Jews in Israel

MethodsResultsDiscussionConclusionsAcknowledgementsAvailability of data and materialsAuthors’ contributionsEthics approval and consent to participateCompeting interestsPublisher’s NoteAuthor detailsReferences